Learning more about HIV

What is HIV?
Do I need to take treatments?
How does the treatment work?
How should I take care of my health?
Can I continue working with HIV?
What about sex and relationships now that I am HIV-positive?
I am worried I may have passed HIV on to someone. What should I do?
Can I be prosecuted for passing on HIV?
Can I have a baby now that I have HIV?
Can I become a father without passing HIV to my child or partner?

Finding out that you have HIV can be a huge shock. The fact that you have HIV may be the only information you can absorb on the day of your diagnosis, but later you may have many questions you need answered. You can find a lot of detailed information about HIV/AIDS in the HIV/AIDS section of this website.

Always ask your doctor, nurse or pharmacist to explain anything you do not understand, and ask for written information if you still have questions or uncertainties. If you want more detailed information on a particular topic you will find the NAM website very helpful http://www.aidsmap.com/ . Printed information and Fact sheets are also available at the ACET information Centre

Below are listed some FAQ’s often asked by people who are newly diagnosed.

What is HIV?

If you are HIV-positive it means you have a virus called HIV (Human Immunodeficiency Virus) in your body. It doesn’t necessarily mean that you are ill, that you have AIDS, or that you are dying.

You can, however pass the virus on to other people if you engage in unprotected sex or share needles or other injecting equipment. An HIV positive woman can also pass the virus on to her baby in the womb, during delivery, or through breast-feeding. However, the use of anti-HIV treatment, having a caesarean delivery, and not breastfeeding can reduce the risk of a mother passing the virus to her baby to less than 1%.

During the early stages of infection the risks of passing HIV on to other people through unprotected sex is at its highest.

Over a period of time HIV slowly attacks the immune system, which is the body’s natural defence system against infections. When the immune system is weakened there is a risk of becoming ill from different infections.

At some stage you may need drug treatments to stop the virus reproducing and damaging the immune system. The drugs will help you stay in good health.

AIDS is different from HIV. It describes an advanced stage of infection when the immune system is very weak. Advances in treatment mean that few people now develop AIDS and those that do can often recover from it.

Do I need to take treatments?

The drugs used to treat HIV are called anti-retroviral drugs and treatment is often called ’combination therapy’ because people usually have to take a combination of three drugs at the same time.

Not everyone with HIV needs to take combination therapy straightaway. If you were infected quite recently, you will probably have good health for several years, without needing to take treatments. If you have only just found out, but have had HIV for many years your doctor may recommend that you start combination therapy straight away. In both cases your HIV specialist will monitor your health and immune system and discuss treatment options with you.

If HIV is making you ill doctors call this ’symptomatic’, if it’s not making you ill, it’s ’asymptomatic’.

Deciding to start treatment also depends on your feelings. Give yourself enough time to find out about your options and make up your own mind. An ACET Support Worker can help you understand the options and decide what is best for you.

How does the treatment work?

Combination therapy usually involves taking tablets once or twice a day. The drugs slow down the spread of HIV in the body. If there is less HIV, there is less damage to your immune system, and you are less likely to get ill. However, combination therapy is not a cure. It cannot entirely eliminate HIV from the body.

Combination therapy only works well if the drugs are taken exactly as prescribed. This means the drugs have to be taken:
· at the right time
· at the right dose
· strictly following any advice about food and drink

How should I take care of my health?

There are many things you can do to care of your health and put your body and immune system under less strain, apart from taking pills. These include:
· getting sufficient rest and sleep
· eating well
· reducing stress
· not smoking
· taking regular exercise

Try to avoid turning to alcohol or drugs to help you forget or stop thinking about things. They might seem to work in the short term but ignoring problems will not make them go away and alcohol and drugs will probably bring their own problems.

Can I continue working with HIV?

If you are currently in work and feeling healthy there is no reason why you should stop work because you have HIV. Treatments mean that most people living with HIV are in good health and able to continue with normal work or studies.

As a general rule, there is no need to tell your employer but it may be easier to arrange time off for appointments or deal with periods of sickness if your employer is aware that you are living with HIV. More information about issues to think about before telling your employer can be found at Should I Tell? on this website.

What about sex and relationships now that I am HIV-positive?

Having HIV can affect people’s feelings in many different ways. Some people feel anxious about passing HIV on, others may feel less desirable, and some may go off sex altogether, whilst others may look for it more and more.

It’s important to know that:

Most people with HIV do continue to have sex and form relationships.
Unprotected anal and vaginal sex have the greatest risk of HIV transmission.
If you are the active, or insertive, partner during unprotected sex, the risk of you passing on HIV is greater than if you are the receptive partner
The risk of passing on HIV is particularly high when you are first infected (Primary HIV Infection) and have a high viral load.
The risk of passing on HIV is also higher if you have an untreated sexually transmitted infection (STI) or if you ejaculate inside your partner
If an HIV-negative person has an untreated STI, their chances of contracting HIV from you during unprotected sex increases.
If you are receptive, or passive, during sex, the risk of passing on HIV during unprotected sex is reduced, but still present, especially if you have a high viral load or untreated STI.
Condoms, when used properly, provide excellent protection against getting most STIs and passing on HIV to other people, or being reinfected with another strain of HIV.
Condoms are usually made of latex. Some people are allergic to latex condoms, in which case polyurethane condoms are a safe alternative.
You should use an water-based lubricant with condoms, as oil-based lubricants weaken condoms and can cause tears.
Some sexually transmitted infections, like syphilis and hepatitis C can be more difficult to treat when you have HIV.
When choosing a contraceptive method, HIV treatments may need to be considered. Some anti-HIV drugs can interact with the pill and other hormonal contraceptives

More detailed information on all these issues can be found at http://www.aidsmap.com/cms1044249.asp

I am worried I may have passed HIV on to someone. What should I do?

If you are worried that you may have just passed HIV on to someone (for example if a condom broke), an emergency treatment called PEP (post exposure prophylaxis) is available. PEP is a course of ant-HIV drugs that must be taken as soon as possible after the risk has been taken.

In Jersey, PEP starter packs are available 24 hours a day from the General Hospital’s Accident and Emergency (A&E) Department and from the Sexual Health Clinic during normal opening hours.

Further information about PEP in Jersey can be found at >HIV/AIDS>HIV Emergency Prevention>INDEX

Can I be prosecuted for passing on HIV?

You may have heard about people being prosecuted for passing on HIV. While it is important to be aware of this, you should know that so far this has only happened to a very small number of people. However, it is important that you have a clear picture of the law.

The legal situation around transmission of HIV is evolving with each court case and information should always be checked for accuracy in light of recent developments. More information can be found at http://www.tht.org.uk/informationresources/prosecutions/

Anyone personally concerned about the possibility of prosecution should contact THT DIRECT on 0845 1221 200 to be put in contact with expert advice as soon as possible.

Further information can also be found at http://www.nat.org.uk/Living-with-HIV/Useful-information/Criminal-prosecutions.aspx

If you are thinking yourself about going to the police to make a complaint, it is important to be aware of the possible consequences for you. It is worth getting advice from an organisation that has experience of these situations, and giving yourself time to think through what is best for you.

If you do go to the police, details of your sex life and sexual partners could be argued over in court, and other people may find out that you have HIV. The process can take a lot of time, and it can become difficult to withdraw a complaint.

Can I have a baby now that I have HIV?

Until recently it was thought that pregnancy could have a negative effect on a woman’s health, as the immune system might be further suppressed by pregnancy. It now seems that pregnancy is only likely to have an impact on a woman’s physical health if she is already unwell, or has very low CD4 counts. There is no evidence that pregnancy accelerates the course of HIV infection in asymptomatic women.

If you are thinking about having a baby speak to your HIV specialist first, so that he can check that you are healthy enough to have a baby safely. He can also tell you about how to get pregnant without putting you partner at risk of infection.

Many women have given birth to healthy children by taking the following precautions:
· taking ant-HIV drugs during pregnancy
· having a caesarean section
· not breastfeeding

If you follow these recommendations, it is extremely unlikely your baby will be HIV positive.

Can I become a father without passing HIV to my child or partner?

HIV can be passed from mother to baby during pregnancy but it cannot be passed directly from the father to the baby. Nevertheless if your partner does not have HIV and you have unprotected sex, there is a risk that she will be infected with HIV.

Sperm-washing is a process that has been developed for couples that wish to have a child, where the male is HIV-positive and the female is HIV-negative. The procedure reduces the risk of HIV transmission to the female partner and subsequently the unborn child.

This technique was pioneered in Milan. To date the programme in Milan has undertaken more than two thousand inseminations and several hundred IVF cycles. So far, none of the women has become HIV-positive and all of the children born have tested HIV-negative. The eldest child is now eleven.

There remains a very small theoretical risk to the woman of HIV transmission. Sperm washing is however, considerably safer than having unprotected sex, but if a couple is certain that they don’t want to take any risk, no matter how minimal, sperm washing would not be a suitable method for them. These couples may prefer to find out more about artificial insemination by donor, which is a risk free alternative.

A sperm-washing service is available at the Chelsea & Westminster (C&W) Hospital. All enquiries regarding the C&W sperm-washing programme should be directed to the Assisted Conception Unit (telephone 020 8746 8585).

Further information about sperm-washing can be found at http://www.aidsmap.com/en/docs/B70324A6-1225-48AA-BDF4-E319525B9EF2.asp

Last updated April 2010